Heart Palpitations / Tachycardia - Symptoms and Causes of Heart Palpitations

Tachycardia isn’t all that uncommon. As soon as we engage in physical activity or get worked up about something, our heart beats faster. A heart rate of 60 to 80 beats per minute is normal for a healthy person and corresponds to what’s known as the resting heart rate. When we’re sleeping or resting, our pulse can be even lower. However, as soon as we’re physically active, our heart beats faster (100 to 120 beats per minute) to adapt to our surroundings. If the pulse remains elevated over a long period, however, it may be a sign of a serious medical condition. In some cases, tachycardia is caused by a heart rhythm disorder in which the heart’s normal electrical activity is disrupted.

It’s not just older people who suffer from a racing heart—young people also struggle with these symptoms. If the racing heart is accompanied by

• nausea
• dizziness
• shortness of breath
• loss of consciousness
• a feeling of pressure in the chest

occur together, tachycardia can be life-threatening. Forms such as ventricular fibrillation are particularly dangerous, as the heart can no longer pump effectively, resulting in a medical emergency.

A racing heart, or tachycardia, is characterized by rapid heartbeats that patients find extremely uncomfortable. As soon as the heart starts racing, those affected experience a sense of inner restlessness. In such cases, a heart rate of more than 100 beats per minute is not uncommon. The accelerated heartbeat is caused by increased activity of the electrical impulses that control the heart’s rhythm. The heart’s primary function is to supply the body and its organs with blood and oxygen. If the heartbeat is disrupted, fainting is one of the potential risks.

Tachycardia is a condition that indicates a disturbance in the heart’s function. This disturbance is not always pathological. A racing heart is mostly caused by physical exertion, excitement, or stress. The symptoms may occur either after physical exertion or while at rest. Often, the pounding sensation in the chest disappears after a few seconds. However, if accompanying symptoms (dizziness, nausea) worsen, an underlying medical condition may be the cause. In some cases, symptoms such as shortness of breath or a feeling of tightness in the chest may also occur, which could indicate a more serious cause.

Usually, these are stress-related symptoms that have little impact on health. However, as soon as the symptoms persist for longer periods or occur more frequently, the health risk increases. Doctors refer to a heart rate of 100 beats per minute or higher as tachycardia. This may be caused by what is known as accelerated electrical activity in the heart muscle, which disrupts the normal rhythm. Often, those affected do not even perceive the symptoms as a racing heart. Instead, they feel a fluttering in the heart or an irregular heartbeat, which, however, does not cause any further discomfort.

However, sudden chest tightness, chest pain, or shortness of breath indicate heart problems that should be evaluated by a medical professional. If left untreated, this can, in the worst-case scenario, lead to a stroke, as cardiac arrhythmias can cause blood clots to form. In the worst-case scenario, a medically caused rapid heartbeat can be fatal if you do not seek medical attention. Heart attacks are still considered the leading cause of death in Germany. After all, one in four deaths is attributable to heart disease. People in large cities are most affected by this. 

A heart attack is usually caused by a blockage in the arteries that supply blood to the heart @ freshidea /AdobeStock

The causes of tachycardia are extremely varied. A racing heart is often the result of stress, excitement, or anxiety. However, that pounding sensation in your chest can also occur when you drink alcohol, black tea, or coffee. If you consume these stimulants before bedtime, a racing heart may occur at night (nocturnal tachycardia). A racing heart can also occur after eating, especially if you’ve had a particularly large and high-fat meal. Additionally,

• nicotine or other drugs
• Fever
• colds
• hormonal changes during pregnancy or menopause
• high blood pressure
• Low blood sugar
• Medications
• Coronary heart disease with arrhythmias
• Hyperthyroidism (overactive thyroid)
• Electrolyte imbalance

are possible causes.

Doctors refer to irregular or rapid heartbeats as atrial fibrillation. Other forms include supraventricular tachycardia and ventricular tachycardia, which differ significantly in their causes and levels of danger. A heart attack occurs when the coronary arteries become completely blocked as a result of advanced atherosclerosis.

The most common causes of atherosclerosis are:

• Smoking
• Obesity
• Diabetes mellitus
• Lack of exercise
• High blood pressure
• High-fat diet
• Lipid metabolism disorders (high blood lipid levels)

If your heart is racing, it’s best to lie down. Breathe calmly and ask a family member for help. If in doubt, call an emergency doctor as soon as your symptoms worsen. Acting quickly is especially important in cases such as an acute heart attack to prevent further damage. If you experience repeated episodes of a racing heart, the cause should be medically evaluated as soon as possible.

If tachycardia persists over an extended period, you should see a doctor to determine the cause, especially if it is accompanied by chest pain or fainting spells. The goal is to make an accurate diagnosis of a racing heart and identify any potential underlying conditions. Specialists in the heart and heart disease are cardiologists—doctors who specialize in cardiology. The doctor will first conduct a thorough interview (medical history) to narrow down the possible causes. The frequency, onset, and progression of the symptoms are particularly important. You’ll also need to indicate whether the symptoms have worsened recently. To determine the exact cause of tachycardia, doctors perform several tests.

These include:

• measuring your pulse and blood pressure
• Listening to the heart with a stethoscope
• Examination of the thyroid gland
• Blood tests (to determine electrolyte and thyroid levels)
• ECG (measurement of heart electrical activity)
• Stress ECG and Holter monitoring
• Echocardiography (ultrasound examination of the heart)
• Chest X-ray
• Angiography (examination of the heart using a cardiac catheter)

These procedures help determine how tachycardia develops and which factors play a role. In some cases, additional tests are performed to rule out other causes.

During a stress ECG, the heart’s activity is monitored while the patient is physically active @ Kzenon /AdobeStock

Depending on the symptoms, the treating physician will treat the tachycardia with specific medications. In cases of severe or chronic problems, the use of a pacemaker may be indicated.

In general, lifestyle changes are recommended. Heart problems are usually caused by being overweight or an unhealthy diet, which is why you should avoid nicotine, alcohol, coffee, and foods high in fat and sugar. Instead, opt for fresh fruits and vegetables, fish, or healthy oils. Flaxseed oil, tomatoes, oatmeal, avocados, soybeans, salmon (omega-3 fatty acids), blueberries, spinach, nuts, and lentils are among the best foods in this regard because they contain healthy fats, antioxidants, and fiber.

Heart palpitations are a phenomenon familiar to many people. Stress, obesity, thyroid disorders, and recreational drugs usually lead to heart palpitations, but a rapid heartbeat can also have other causes. It is crucial to identify the individual factors, as there may be various underlying causes. Since tachycardia can be life-threatening, those affected should have the symptoms evaluated by a cardiologist. A cardiological evaluation is particularly important in cases of recurrent heart palpitations.

1. What is a racing heart?
Colloquially, a racing heart refers to when the heart beats significantly faster than normal and the person experiences a rapid, pounding sensation.

2. What are the possible causes of a racing heart?
There are various causes—ranging from stress and anxiety to physical conditions that can trigger a racing heart.

3. When should a rapid heartbeat be evaluated by a doctor?
If a rapid heartbeat occurs for no apparent reason, persists for a long time, or is accompanied by symptoms such as dizziness, it should be evaluated by a doctor.

4. Can a racing heart also have psychological causes?
Yes, in addition to physical triggers, psychological factors such as anxiety or stress can also cause a racing heart.